title: Outcomes of pregnancy in women who had rescue cerclage for cervical insufficiency: a single-center retrospective study.
abstract: OBJECTIVE
  The aim of this study was to evaluate outcome of pregnancies in women with rescue cerclage for cervical insufficiency.
  
  
  METHODS
  A retrospective study of all women who underwent rescue cerclage between 2002 and 2011 at an advanced tertiary care perinatal institute in India was conducted. Data retrieved from medical records was used to explore potential associations with prolongation of pregnancy beyond 28 weeks.
  
  
  RESULTS
  The mean (standard deviation) gestational age at cerclage was 21.9 (2.7) weeks for the 74 women in the study. The McDonald technique was the preferred method for rescue cerclage (91.9%). All women received antibiotics; tocolytics were used in 35.1% and progesterones in 62.2% of women. The mean prolongation of pregnancy was 7.4 weeks with 42.0% women delivering after 28 weeks and 30.4% after 34 weeks. The take-home-baby rate was 50.7% (95% confidence interval: 38.7-62.6%). Postoperative vaginal infection was present in 16.2% of women, preterm premature rupture of membranes in 31.1% of women and neonatal sepsis in 5.8% of neonates. Cerclage placement after 20 weeks and negative pathogenic organisms in vaginal swab culture were significantly associated with delivery beyond 28 weeks.
  
  
  CONCLUSIONS
  Although half of the women had successful pregnancy outcomes after rescue cerclage, pregnancy extended from previability to prematurity in most of them.
authors.affiliation: Department of Gynaecology, Fernandez Hospital, Hyderabad, India. drsirisha.g@fernandezhospital.com
authors.forename: Sirisha Rao
authors.initials: SR
authors.lastname: Gundabattula
authors.forename: Lakshmi Rathna
authors.initials: LR
authors.lastname: Marakani
authors.forename: Shashikala
authors.initials: S
authors.lastname: Dasari
authors.forename: Kameswari
authors.initials: K
authors.lastname: Surampudi
authors.forename: Manjula
authors.initials: M
authors.lastname: Pochiraju
authors.forename: Praveen Kumar
authors.initials: PK
authors.lastname: Nirmalan
mesh_terms: D000328:Adult; D023802:Cerclage, Cervical / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D002581:Uterine Cervical Incompetence / Q000601:surgery*; D055815:Young Adult
keywords: incompetent cervix; pregnancy loss; premature labor; prematurity; recurrent pregnancy loss; risk assessment and prevention